Surgical treatment of left ventricular free wall rupture after acute myocardial infarction
| Autor: | Luís Augusto Palma Dallan, Richard Halti Cabral, Fernando Platania, Rogério Bordallo, Luís Alberto Oliveira Dallan, Sérgio Almeida de Oliveira, Carlos Alberto Cordeiro de Abreu Filho, José Carlos R Iglézias, Luiz Augusto Ferreira Lisboa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system RD1-811 lcsh:Surgery Hemodynamics Rotura cardíaca pós infarto Infarto do miocárdio/complicações Overall survival medicine Diseases of the circulatory (Cardiovascular) system Myocardial infarction Ischemic complication Severe complication Surgical team business.industry Cardiac Rupture Infarto do miocárdio General Medicine lcsh:RD1-811 Surgical correction medicine.disease Ventrículo cardíaco Surgery lcsh:RC666-701 RC666-701 Ventrículo cardíaco/cirurgia Cardiology and Cardiovascular Medicine business Heart ventricle Heart rupture post-infartion |
| Zdroj: | Brazilian Journal of Cardiovascular Surgery, Vol 17, Iss 1, Pp 06-12 (2002) Brazilian Journal of Cardiovascular Surgery, Volume: 17, Issue: 1, Pages: 06-12, Published: MAR 2002 Brazilian Journal of Cardiovascular Surgery v.17 n.1 2002 Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV |
| ISSN: | 1678-9741 0102-7638 |
| Popis: | CASUÍSTICA E METODOS: Entre janeiro de 1983 e maio de 1999, 12.405 pacientes com diagnóstico de infarto agudo do miocárdio (IAM) foram atendidos no InCor. Destes, 127 (1,02%) apresentaram rotura de parede livre do ventrículo esquerdo como complicação do IAM. A rotura miocárdica aguda ocorreu em 98 (77,1%) pacientes e a subaguda em 29 (22,9%). RESULTADOS: Foram operados 5 pacientes na forma aguda, com 80% de mortalidade e 19 na forma subaguda, com 15,8% de mortalidade. A sobrevida pós-operatória abrangendo os dois grupos foi de 70,8%. CONCLUSÃO: Concluímos que a rotura de parede livre do ventrículo esquerdo é uma grave complicação do IAM, necessitando de atuação imediata. Nas formas agudas, observa-se rápida deterioração hemodinâmica do paciente, muitas vezes sem tempo hábil para tentativa de correção cirúrgica. As formas subagudas podem ser detectadas e monitorizadas através de exames ecocardiográficos seriados após o IAM. Nestes casos a intervenção cirúrgica precoce, muitas vezes sem a necessidade de instalação de circulação extracorpórea, tem contribuído para a sobrevida da maioria dos pacientes. MATERIAL AND METHODS: Between January 1983 and May 1999, 12.405 patients were treated by the surgical team of the Heart Institute (InCor) with the diagnosis of acute myocardial infarction (AMI). From these patients, 127 (1.02%) had left ventricular free wall rupture as an ischemic complication of the myocardial infarction. The cardiac rupture was acute in 98 patients (77.1%) and sub-acute in 29 (22.9%). RESULTS: Twenty-four patients were operated on, 5 on acute rupture with 80% of hospital mortality and 19 on sub-acute rupture with 15.8% of hospital mortality. The post-operative overall survival including both groups was 70.8%. CONCLUSION: The conclusion was drawn that left ventricular free wall rupture is a severe complication of acute myocardial infarction that needs an immediate action. In acute ruptures, most patients develop hemodynamic deterioration without enough time to try to proceed any surgical correction. The sub-acute cases can be detected and monitored through periodic ecocardiographic exams after the AMI. In these cases the early surgical intervention, many times without using extra-corporeal circulation, has been increasing the chances of survival of the majority of these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|